The term ‘retirement community’ was coined in the 1960s in Phoenix, Arizona. It basically meant a place to bung the parents which didn’t make you feel too guilty. Not surprisingly, they caught on.
It was not for another twenty years that nurses, doctors, patients and relatives – everyone, basically – noticed that retirement homes made their occupants miserable. The next generation of institution was called ‘assisted living’ and was pioneered in Oregon by a nurse and entrepreneur called Keren Wilson in 1980. Wilson argued that the care homes were basically set up to maximise the health and safety of the occupants and minimise work for the owners. They were holding-pens for old people, whose lives were reduced to the absolute minimum acceptable to their children and legislation. A small room, a TV, two photographs and a wardrobe. Keren made the startling observation that the same thing that made life worth living for young people, did the same for old. It turned out whatever our age, we all wanted to fully live our lives rather than simply exist. And she said ‘Let’s let these geriatrics have pets and visitors if and when they want to, and go to bed and get up whenever suits them.’ If they wanted to lie in all day, that was fine, Keren said. Let them. They were old enough to know what they wanted. And she advocated giving them a door that only they could lock, from both sides. Privacy, and a degree of self-determination had been removed from their lives to suit the staff rota, basically. Keren also insisted that the occupants of her homes be given kitchens and the freedom to cook what they wanted. That meant the oldies were going to be in possession of a knife, which of course ran against all the instincts of the managers, who had stripped anything that might cause a problem, including the old people’s personalities, out of their system.
The experiment was a success. Doctors made the not-so-extraordinary discovery that if you gave old people a degree of joy, creativity and choice, they didn’t decay and decline so catastrophically. It turned out that three hours a week of crochet, bingo and arm yoga was not sufficient to make them want to go on living. And I didn’t blame them. Some places took Keren Wilson’s theory further. A bored and clever care-home doctor in New York called Bill Thomas introduced dogs, cats and 100 parakeets into his care home and – surprise, surprise – it encouraged the occupants to be less reliant on drugs and live longer, because they had to deal with the responsibilities and rewards of caring for these animals.
The problem was that creating a building that was full of the unpredictability and challenges of a genuine domestic home was all a bit too much like hard work for the care-home owners. The staff I had seen at Nanna’s Salford care home didn’t seem to be up for it at all. They looked overweight and bored. They carefully did the minimum required to keep their job and stay out of trouble. Their sensitivity was reserved not for the patients but for their own employment rights. I had watched a table of staff on their break drinking mugs of instant coffee, checking their watches and ignoring the patients, before heaving themselves onto their ostentatiously flat shoes and shlepping off to do the next thing only because it had to be done.
I started designing my own old people’s home, based on Wilson’s, Thomas’ and my own principles of what made life worth living. I pictured a large ramshackle country mansion by the sea with a big lawn out front and greenhouse and weedy veg garden out back. The decor was fading-country-house: beautiful threadbare rugs, well worn classic English furniture and open fires with baskets of split logs that occupants could pick up and throw on the grate.
There were no fire doors, and no emergency signage anywhere. In fact there were no signs of any kind, because signs mean authority. There was a swimming pool, jacuzzi, steam room and sauna, all open round the clock, none with lifeguards giving orders. Masseurs were available whenever you wanted one.
In the drawing room the drinks tray was well stocked. The nurses’ job was not to purée my dinner but to fill the goddam ice bucket and get that tricky champagne cork off.
Activities included deep-sea fishing for mackerel – life jackets optional. But someone might fall in. Yes indeed. But as I will have survived for eighty years doing more or less exactly what I wanted, I think I know more about my own safety than some care professional. Also popular would be picnics close to the cliff edge and trips to the local race course or dog track. Drugs would be on tap, but not the type prescribed by some pipsqueak doctor in a white coat. The purveyor of drugs to my care home would I very much hope be wearing leather trousers, have neck tattoos and sell us occupants whatever we needed or wanted, the two not being synonymous. I come from a generation that knows more about drugs than any medical doctor that I have encountered. I want cocaine, on occasion, a good pipe of hash when called for, and a tab of acid from time to time to do with my mates in the day room, or, if sunny, lying on cushions on thick Persian rugs on the lawn. Culturally, we would have talks from leading (not local) authors and film-makers. In a top-of-the-range screening room we’d watch some good movies, the choice of which the staff would have absolutely NO say in. We would go to the theatre from time to time. Not some lame local production, but the RSC or The National. There would be ample spare rooms for visits of any length by friends and family. Everyone would have a double bed, linen sheets and goose-down pillows. Six of them. And the bed would go up and down by electric motor. We would submit to no medical tests or surveys unless we requested them. The doctor would be someone we gave orders to, not the other way round. The only concessions to decrepitude I could think of apart from the electric beds was that there should be a lift.